nerve damage to groin and hip area after illiac crest bone harvest. what's it called and is it reversable? six months post op. cervical fusion of c6-c7 with autograft from hip and hardware. sensations range from numb, sharp quick pins and needles and sand
2 doctor answers • 5 doctors weighed in
Hand Surgery 28 years experience
There : There are a few nerves around the pelvis that could be injured during graft harvest. The most common one is the lateral femoral cutaneous nerve which supplies the skin on the outside of the thigh. From your description, it is more likely the ilioinguinal or pedundal nerve that is affected. Since i don't know where the bone was harvested (anterior or posterior crest), i don't know how the nerve might have been injured.
Most of these nerve injuries are what are called neurapraxias. The nerves recover with time, but can be painful for several months to a year. A charring injury from the cautery used during surgery also recovers with time.
If the nerve is partially (axonotmesis) or completely (neurotmesis) severed, the recovery is less predictable. The nerve fibers have to regrow and find their way to the nerve endings. If they "get lost" they can cause a painful ball of nerve fibers called a neuroma. Nerves take a month to start growing and grow at 1mm/day or about an inch a month. Based on the location of the injury and the distance to the nerve endings, it can take a long time to regenerate.
Injured nerves can be very irritable and send any stimulus as a painful signal. To quiet the nerve, we use desensitization techniques. By constantly giving the nerve a low level stimulus, it "learns" what is normal and stops the painful signal. Then you increase the stimulation until that feels normal.
While Neurontin can be helpful, I have had better pain control (though not necessarily side effects) with lyrica (pregabalin). Insurers are often reluctant to cover it because it's more expensive. Amitriptyline or nortriptyline can enhance the effects, but also add to the sedation.
It is possible you may need surgery to explore the nerve and remove a possible neuroma, though that would likely leave an area of numbness. Only your surgeon knows what the likelihood of that is. Nerve conduction studies usually are not very helpful in this area and can be painful to get, particularly if the nerve is quite irritable.
To date we do not have any means of making nerves function. We can decompress them, repair them, remove neuromas, and even transfer them, but they have to work on their own. Maybe in the future we will have nerve growth factors or stem cells to help boost nerve function. For now, however, nerve pain remains a frustratingly difficult problem.
5.3k viewsReviewed >2 years ago
Orthopedic Spine Surgery 32 years experience
No, not usually: During harvest of the hip graft, the anterior femoral cutaneous nerve was most likely injured. This nerve runs over the hip very close to where we take the graft. It can heal over a 12 month period, but if you are 6 months from surgery and still have not improved, then it is unlikely to get better.
4.9k viewsReviewed >2 years ago
A 32-year-old member asked:
I have dull sciatic pain from left back to left ankle, acute pain in left butt bone when sitting/sleeping, and sharp groin pains from full bladder!?
2 doctor answers • 4 doctors weighed in
Family Medicine 28 years experience
Self diagnosis?: The symptoms you are descrbing sound like classic sciatica. The remedies are various; my favorite is lyying on your stomach and sliding as far to the left of the bed as possible so your left leg can hang off the side(without falling off of course). Simply allow the leg to 'hang' off the side and you should feel the strectch through your low back including the pyriformis muscle pinching your nerv.
6.2k viewsAnswered >2 years ago
A 25-year-old member asked:
I'm 25 my bones ache.. have lots of headache migraines eye twitches ..body aches a lot no strength ..weak. no energy what should I do?
3 doctor answers • 6 doctors weighed in
Pain Management 48 years experience
6.1k viewsReviewed >2 years ago
A 28-year-old female asked:
Lower right abdominal pain, with hip tenderness accompanied by nausea and radiating lower back pain. Two endometriosis surgeries already and 6 months of lupron (leuprolide). Also had an appentectomy. Is the endo back!?
1 doctor answer • 2 doctors weighed in
Gastroenterology 35 years experience
Surg. complication?: It would appear either the original process continues unabated or there is a surgical complication. I suggest you see the original surgeon (probably your ob-gyn doc).
5.7k viewsReviewed >2 years ago
A 34-year-old female asked:
What could cause parethesia of the head, face, neck and left arm and leg? Ct/mri of the brain are normal. Cymbalta or nucynta (tapentadol) cause this? It's been constant for 3 weeks!
2 doctor answers • 3 doctors weighed in
Internal Medicine 36 years experience
Yes: It is cymbalta, (duloxetine) u should stop it first.
5.7k viewsReviewed >2 years ago
Rockville Centre, NY
A 36-year-old female asked:
39+ weeks pregnant, 3 CM dilated, 0% effaced - rock solid cervix as dr described. In such pain, discomfort (pelvic pressure, back pain)....Difficulty walking. 2nd baby....How long can I go on before cervix begins to soften? Dr willing to induce if I st
2 doctor answers • 9 doctors weighed in
Specializes in Maternal-Fetal Medicine
Depends on situation: Your question is a great one but was cut off. So your doctor is willing to induce under certain circumstances? I am not sure what he plans so cannot comment on the specific case. In general, a cervix that is 3 cm in someone who has had a previous vaginal delivery will efface by the due date. If discomfort, then some physicians will consider inducing labor (amniotomy, eg) each case varies though.
5.7k viewsReviewed >2 years ago
Last updated Oct 3, 2016
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